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Published Online: 1 July 2013

Psychodynamic Therapy and Cognitive-Behavioral Therapy in Social Anxiety Disorder: A Multicenter Randomized Controlled Trial

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Falk Leichsenring, D.Sc., Simone Salzer, D.Sc., Manfred E. Beutel, M.D., Stephan Herpertz, M.D., Wolfgang Hiller, Ph.D., Juergen Hoyer, Ph.D., Johannes Huesing, D.rer.medic., … Show All … , Peter Joraschky, M.D., Bjoern Nolting, M.D., Karin Poehlmann, Ph.D., Viktoria Ritter, M.Sc., Ulrich Stangier, D.Sc., Bernhard Strauss, Ph.D., Nina Stuhldreher, M.Sc., Susan Tefikow, M.Sc., Tobias Teismann, Ph.D., Ulrike Willutzki, Ph.D., Joerg Wiltink, M.D., and Eric Leibing, D.Sc.Authors Info & Affiliations
Publication: American Journal of Psychiatry
Volume 170, Number 7
https://doi.org/10.1176/appi.ajp.2013.12081125
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Abstract

Objective

Various approaches to cognitive-behavioral therapy (CBT) have been shown to be effective for social anxiety disorder. For psychodynamic therapy, evidence for efficacy in this disorder is scant. The authors tested the efficacy of psychodynamic therapy and CBT in social anxiety disorder in a multicenter randomized controlled trial.

Method

In an outpatient setting, 495 patients with social anxiety disorder were randomly assigned to manual-guided CBT (N=209), manual-guided psychodynamic therapy (N=207), or a waiting list condition (N=79). Assessments were made at baseline and at end of treatment. Primary outcome measures were rates of remission and response, based on the Liebowitz Social Anxiety Scale applied by raters blind to group assignment. Several secondary measures were assessed as well.

Results

Remission rates in the CBT, psychodynamic therapy, and waiting list groups were 36%, 26%, and 9%, respectively. Response rates were 60%, 52%, and 15%, respectively. CBT and psychodynamic therapy were significantly superior to waiting list for both remission and response. CBT was significantly superior to psychodynamic therapy for remission but not for response. Between-group effect sizes for remission and response were small. Secondary outcome measures showed significant differences in favor of CBT for measures of social phobia and interpersonal problems, but not for depression.

Conclusions

CBT and psychodynamic therapy were both efficacious in treating social anxiety disorder, but there were significant differences in favor of CBT. For CBT, the response rate was comparable to rates reported in Swedish and German studies in recent years. For psychodynamic therapy, the response rate was comparable to rates reported for pharmacotherapy and cognitive-behavioral group therapy.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Volume 170 • Number 7 • July 2013
Pages: 759 - 767
PubMed: 23680854

History

Received: 28 August 2012
Revision received: 28 November 2012
Revision received: 8 January 2013
Accepted: 18 January 2013
Published online: 1 July 2013
Published in print: July 2013

Authors

Details

Falk Leichsenring, D.Sc.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Simone Salzer, D.Sc.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Manfred E. Beutel, M.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Stephan Herpertz, M.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Wolfgang Hiller, Ph.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Juergen Hoyer, Ph.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Johannes Huesing, D.rer.medic.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Peter Joraschky, M.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Bjoern Nolting, M.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Karin Poehlmann, Ph.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Viktoria Ritter, M.Sc.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Ulrich Stangier, D.Sc.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Bernhard Strauss, Ph.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Nina Stuhldreher, M.Sc.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Susan Tefikow, M.Sc.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Tobias Teismann, Ph.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Ulrike Willutzki, Ph.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Joerg Wiltink, M.D.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Eric Leibing, D.Sc.
From the Clinic of Psychosomatics and Psychotherapy, Justus-Liebig-University Giessen, Giessen, Germany; Department of Psychosomatic Medicine and Psychotherapy, University Medicine, Georg-August-University Goettingen, Goettingen, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, University Medical Center and Clinical Psychology and Psychotherapy, Johannes Gutenberg University Mainz, Mainz, Germany; Clinic of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, and Clinical Psychology and Psychotherapy, Ruhr-University Bochum, Bochum, Germany; Clinical Psychology and Psychotherapy and Clinic for Psychotherapy and Psychosomatic Medicine, Technical University Dresden, Dresden, Germany; Coordination Center for Clinical Trials, University of Heidelberg, Heidelberg, Germany; Clinical Psychology and Psychotherapy, Goethe University Frankfurt, Frankfurt, Germany; Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Jena, Germany; and Department of Medical Sociology and Health Economics, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf.
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Notes

Address correspondence to Dr. Leichsenring ([email protected]).

Funding Information

Dr. Beutel has received speaking honoraria from Pfizer, Shire, and Boehringer Ingelheim. Dr. Herpertz has received speaking honoraria from Lilly Germany and Novo Nordisk Germany. Dr. Hoyer has received speaking honoraria from AstraZeneca. The other authors report no financial relationships with commercial interests.
Supplementary Material
Supported by a grant from the German Federal Ministry of Education and Research, 01GV0607.

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